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ObjectiveTo investigate the therapeutic effect of Baihe Wuyaotang （BWT） on non-alcoholic fatty liver disease （NAFLD） and elucidate its underlying mechanism. MethodC57BL/6J mice were randomly assigned to six groups： normal control， model， positive drug （pioglitazone hydrochloride 1.95×10-3 g·kg-1）， and low-， medium-， and high-dose BWT （1.3，2.5 and 5.1 g·kg-1）. Following a 12-week high-fat diet （HFD） inducement， the mice underwent six weeks of therapeutic intervention with twice-daily drug administration. Body weight was monitored weekly throughout the treatment period. At the fifth week， glucose tolerance （GTT） and insulin tolerance （ITT） tests were conducted. Subsequently， the mice were euthanized for the collection of liver tissue and serum， and the subcutaneous adipose tissue （iWAT） and epididymal adipose tissue （eWAT） were weighed. Serum levels of total triglycerides （TG） and liver function indicators，such as alanine aminotransferase （ALT） and aspartate aminotransferase （AST）， were determined. Histological examinations， including oil red O staining， hematoxylin-eosin （HE） staining， Masson staining， and transmission electron microscopy， were performed to evaluate hepatic lipid deposition， pathological morphology， and ultrastructural changes， respectively. Meanwhile， Western blot and real-time quantitative polymerase chain reaction （Real-time PCR） were employed to analyze alterations， at both gene and protein levels， the insulin signaling pathway molecules， including insulin receptor substrate 1/2/protein kinase B/forkhead box gene O1 （IRS1/2/Akt/FoxO1）， glycogen synthesis enzymes phosphoenolpyruvate carboxy kinase （Pepck） and glucose-6-phosphatase （G6Pase）， lipid metabolism-related genes stearoyl-coA desaturase-1 （SCD-1） and carnitine palmitoyltransferase-1 （CPT-1）， fibrosis-associated molecules α-smooth muscle actin （α-SMA）， type Ⅰ collagen （CollagenⅠ）， and the fibrosis canonical signaling pathway transforming growth factor-β1/drosophila mothers against decapentaplegic protein2/3（TGF-β1/p-Smad/Smad2/3）， inflammatory factors such as interleukin（IL）-6， IL-8， IL-11， and IL-1β， autophagy markers LC3B Ⅱ/Ⅰ and p62/SQSTM1， and the expression of mammalian target of rapamycin （mTOR）. ResultCompared with the model group， BWT reduced the body weight and liver weight of NAFLD mice（P<0.05， P<0.01）， inhibited liver lipid accumulation， and reduced the weight of white fat： it reduced the weight of eWAT and iWAT（P<0.05， P<0.01） as well as the serum TG content（P<0.05， P<0.01）. BWT improved the liver function as reflected by the reduced ALT and AST content（P<0.05， P<0.01）. It improved liver insulin resistance by upregulating IRS2， p-Akt/Akt， p-FoxO1/FoxO1 expressions（P<0.05）. Besides， it improved glucose and lipid metabolism disorders： it reduced fasting blood glucose and postprandial blood glucose（P<0.05， P<0.01）， improved GTT and ITT（P<0.05， P<0.01）， reduced the expression of Pepck， G6Pase， and SCD-1（P<0.01）， and increased the expression of CPT-1（P<0.01）. The expressions of α-SMA， Collagen1， and TGF-β1 proteins were down-regulated（P<0.05， P<0.01）， while the expression of p-Smad/Smad2/3 was downregulated（P<0.05）， suggesting BWT reduced liver fibrosis. BWT inhibited inflammation-related factors as it reduced the gene expression of IL-6， IL-8， IL-11 and IL-1β（P<0.01） and it enhanced autophagy by upregulating LC3B Ⅱ/Ⅰ expression（P<0.05）while downregulating the expression of p62/SQSTM1 and mTOR（P<0.05）. ConclusionBWT ameliorates NAFLD by multifaceted improvements， including improving IR and glucose and lipid metabolism， anti-inflammation， anti-fibrosis， and enhancing autophagy. In particular， BWT may enhance liver autophagy by inhibiting the mTOR-mediated signaling pathway.
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Objective:To investigate the quality of sleep in primary Sj?gren′s syndrome (pSS) patients and its impact on clinical features.Methods:One hundred patients with pSS who were hospitalized in the Department of Rheumatology of the Second Hospital of Shanxi Medical University from January 2019 to April 2021 were included into this study. Pittsburgh sleep quality index (PSQI), fatigue severity score (FSS), Euro QOL five dimensions questionnaire (EQ-5D), beck depression inventory second edition (BDⅠ-Ⅱ) and visual analog scale (VAS) were used to assess patients' symptoms and overall condition. The data was statistically managed and compared by χ2 test, independent sample t test, Mann-Whitney U test, and Logistic regression. Results:The prevalence of sleep disorders in pSS patients was 42.0%(42/100). The prevalence of sleep disturbance in pSS patients without depression was 28.8%(17/59). The EQ-5D[0.66(0.59, 0.76)] and Eur-opean league against rheumatism Sj?gren's syndrome disease activity index (ESSDAI) scores [1.0(0.0, 3.0)] were lower in patients in the sleep-disordered group than in those [0.76(0.71, 1.20) and 2.5(1.0, 4.0)] who slept well [ Z=3.07, P=0.012; Z=3.18, P=0.011], respectively. The European league against rheumatism Sj?gren's syndrome patients report index (ESSPRI) scores [6.2(4.8, 7.9)], VAS levels in overall dry eyes [60.0(21.4, 82.1)], anxiety [11.0(2.9, 43.0)], overall physician global assessment (PGA) [46.0(18.0, 65.0)], fatigue severity scale (FSS) [4.34(3.01, 5.61)], and BDⅠ-Ⅱ [15.1(7.3, 22.4)] in patients with sleep disorder were higher than those [4.1(2.8, 5.3), 40.0(7.0, 70.3), 2.3(0.0, 18.0), 11.0(0.0, 52.0), 2.45(1.65, 4.40), and 7.4(4.3, 12.8)] of the normal sleep group [ Z=2.03, P=0.043; Z=2.04, P=0.042; Z=2.19, P=0.031; Z=3.00, P=0.015; Z=3.43, P=0.001; Z=3.12, P=0.003]. The sleep-disordered group had higher levels of lymphocyte count (2.0±1.5)×10 9/L and erythrocyte sedimentation rate (ESR) (46±20) mm/1 h respectively when compared with (1.4±1.3)×10 9/L and (38±17) mm/1 h in the good sleep group ( t=2.00, P=0.048; t=2.04, P=0.044). PSQI scores were negatively correlated with immunoglobulin (Ig)G ( r=-0.20, P=0.012) and ESSDAI ( r=-0.26, P=0.004), while positively correlated with FSS( r=0.38, P=0.001), BDⅠ~Ⅱ ( r=0.47, P=0.014), ESSPRI ( r=0.46, P=0.001), white blood cell count ( r=0.28, P=0.013) or neutrophil count ( r=0.26, P=0.009). The results of multifactorial analysis suggested that leukocytopenia [ OR(95% CI)=0.245(0.065, 0.692), P=0.005] was one of the risk factors for sleep disorders. Conclusion:Sleep disorders in pSS patients affects the patients' disease prognosis and activity index by affecting the patients' somatic symptoms, psychological profile and immune function. Active clinical multidis-ciplinary interventions for pSS patients are necessary, not only for better assisting physicians in the manage-ment of chronic diseases, but also for better help patients recovery of their physical and mental health.
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Objective To observe the changes ofchoroidal capillary flow area (CBFA) and density in patients with idiopathic macular hole (IMH) before and after surgery.Methods A prospective clinical study.Thirty patients (60 eyes) with unilateral IMH diagnosed in Department of Ophthalmology of The Second Hospital of Hebei Medical University from February 2017 to March 2018 and 30 age-and sex-matched normal controls were included in this study.All eyes were divided into group A (30 affected eyes),group B (30 fellow eyes) and group C (30 normal eyes of controls).Among 30 eyes in group A,there were 5,14,11 eyes with hole in stage Ⅱ,Ⅲ,Ⅳ,respecitvely.The eyes in group A were divided into two subgroups according to the diameter of the holes:group D:hole diameter less than or equal to 500 μm (11 eyes),group E:hole diameter over than 500 μm (19 eyes).All eyes in group A underwent vitrectomy.Spectral-domain OCT was used to observe the diameter size of macular hole and the closure of the hole after vitrectomy in eyes of group A.The CBFA and blood flow density of superticial choroidal capillaries were measured by OCT angiography before and 3 months after vitrectomy in groups A,B and C.Univariate analysis of variance and t test were used for statistical analysis.Results Before surgery,in group A,B and C,the CBFA were 2.84± 0.35,3.19± 0.23,3.26±0.24 mm2,the blood flow density were (20.74 ± 8.26)％,(35.18 ± 5.20)％,(35.20± 6.49)％,respectively.The CBFA and blood flow density in group A were significantly lower than those in group B and C (F=19.768,45.583;P =0.000,0.000),but there was no significant difference between group B and C (F=19.768,45.583;P=0.332,0.994).The CBFA and blood flow density in group D were higher than those in group E (t=2.230,2.202;P=0.034,0.036).The diameter of macular hole was negatively correlated with CBFA and blood flow density (r=-0.377,-0.477;P=0.044,0.009).Three months after surgery,the macular holes in group A were closed;CBFA and blood flow density in macular area were significantly higher than before surgery (t=-4.126,-4.912;P=0.000,0.000).Conclusions CBFA and blood flow density decreased in the macular area ofIMH.CBFA and blood flow density can be recovered after vitrectomy.
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Objective ToexplorethenoiselevelsfromdifferentMRIsequencesandtheeffectsofMRInoiseonhearingfunction ofthesubjectswithtraditionalhearingprotection measures.Methods Intheprocessofscanningvolunteerswith MRI,soundlevel metersandelectretcapacitancemicrophoneswereusedsimultaneouslytodetectthenoiselevelsofdifferentMRIsequencesanddifferentpositionsof magnets,analyzingthe MRInoiserangeanddistributioncharacteristics.Dynamicauditorybrainstem response(ABR)wasusedto measurethehearingthresholdsof100healthyadultvolunteerswithtraditionalhearingprotection measures,respectivelywithin24 hoursbeforeMRIexamination (test1),within20minutesafterMRIexamination(test2),and25daysafterMRIexamination(test 3),estimatingthehearinglossandrecoveryofthesubjects.Results ThenoisevaluesofdifferentMRIsequencesweredifferent,the peakofsoundpressurelevel[Lpeak]rangedfrom119.7to124.5dB(A),theequivalentweightedsoundpressurelevel[Leq]ranged from103.5to115.3dB(A).DynamicABRresultsshowedthehearingthresholdsoftest2onbothleftandrightearsweresignificantlyhigher thanthoseoftest1(L:P=0.012;R:P=0.001);while,havingcomparedthehearingthresholdsofleftandrightearsintest3with thoseintest1,therewerenosignificantdifferences(L:P=0.138;R:P=0.451).Conclusion Thenoiseof3.0T MRIcancausethe hearingthresholdsofhealthyadultswithtraditionalhearingprotectionmeasuresincreasetemporarily,whenscanningwithMRI,more effectivemeasuresshouldbetakentoreducethehearingnoiseandprotectthehearingfunctionofthesubjects.
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Objective@#To observe the changes of choroidal capillary flow area (CBFA) and density in patients with idiopathic macular hole (IMH) before and after surgery.@*Methods@#A prospective clinical study. Thirty patients (60 eyes) with unilateral IMH diagnosed in Department of Ophthalmology of The Second Hospital of Hebei Medical University from February 2017 to March 2018 and 30 age-and sex- matched normal controls were included in this study. All eyes were divided into group A (30 affected eyes), group B (30 fellow eyes) and group C (30 normal eyes of controls). Among 30 eyes in group A, there were 5, 14, 11 eyes with hole in stage Ⅱ, Ⅲ, Ⅳ, respecitvely. The eyes in group A were divided into two subgroups according to the diameter of the holes: group D: hole diameter less than or equal to 500 μm (11 eyes), group E: hole diameter over than 500 μm (19 eyes). All eyes in group A underwent vitrectomy. Spectral-domain OCT was used to observe the diameter size of macular hole and the closure of the hole after vitrectomy in eyes of group A. The CBFA and blood flow density of superficial choroidal capillaries were measured by OCT angiography before and 3 months after vitrectomy in groups A, B and C. Univariate analysis of variance and t test were used for statistical analysis.@*Results@#Before surgery, in group A, B and C, the CBFA were 2.84±0.35, 3.19±0.23, 3.26±0.24 mm2, the blood flow density were (20.74±8.26)%, (35.18±5.20)%, (35.20±6.49)%, respectively. The CBFA and blood flow density in group A were significantly lower than those in group B and C (F=19.768, 45.583; P = 0.000, 0.000), but there was no significant difference between group B and C (F=19.768, 45.583; P=0.332, 0.994). The CBFA and blood flow density in group D were higher than those in group E (t=2.230, 2.202; P=0.034, 0.036). The diameter of macular hole was negatively correlated with CBFA and blood flow density (r=-0.377, -0.477; P=0.044, 0.009). Three months after surgery, the macular holes in group A were closed; CBFA and blood flow density in macular area were significantly higher than before surgery (t=-4.126, -4.912; P=0.000, 0.000).@*Conclusions@#CBFA and blood flow density decreased in the macular area of IMH. CBFA and blood flow density can be recovered after vitrectomy.
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Objective To assess the correlation between sleep quality and disease activity in rheumatoid arthritis (RA) patients by comparing the sleep quality of RA patients with healthy control group.Methods One hundred and sixty cases of RA patients who were hospitalized in the Second Hospital of Shanxi Medical University from January 2015 to June 2017 were included into this study,and 90 age and gender matched healthy people were selectedas control group.Age,sex,therapeutic drugs,Pittsburgh Sleep Quality Index (PSQI),serum erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),the 28-joint Disease Activity Score (DAS28),Visual Analogue Score (VAS) and Beck Depression Inventory second edition (BDI-Ⅱ) were detected and compared.According to the DAS28 scores,the relationship between the sleep quality of RA patients and the degree of disease activity was analyzed.Results One hundred and nine cases (68.1％) with sleep disorders in the RA group,which was higher than that in the healthy control group,in which 17 cases (18.9％) had sleep disorder.The total scores of the PSQI in the RA group were higher than those in the healthy control group,which were (7.2±3.2) scores vs (3.1±2.8) scores (t=10.636,P＜0.05) respectively.In the RA group,the average age of patients with sleep disorders (PSQI＞5) (56±12) years was higher than that of patients without sleep disorders (48±9) years (PSQI≤5).The VAS and BDI-Ⅱ score in RA patients with sleep distur-bance were higher than those with non-sleep disturbance,which were (5.8±2.2) scores vs (25.1 ±9.1) scores vs (2.1 ±2.1) scores vs (14.2±6.6) scores (P＜0.05) respectively.According to the results of Pearson correlation an-alysis,DAS28 was significantly positively correlated with BDI-Ⅱ (r=0.382,P=0.001),PSQI wassignificantly positively-correlated with BDI-Ⅱ (r=0.312,P=0.001).Subjective sleep quality,sleep time,sleep efficiency,sleep disorder,daytime dysfunction and the PSQI total score increased with the increase of RA activity.Conclusion The incidence of sleep disturbance in RA patients is higher than that in the normal population.The incidence of sleep disturbance,increases significantly accompanied by high disease activities in RA patients.
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Objective To explore the application values of magnetic resonance diffusion weighted imaging (DWI)and diffusion tensor imaging (DTI)in the early diagnosis of cerebral infarction.Methods 1 2 1 patients with single side cerebral infarction were di-vided into five groups by disease time,the brain examination was performed by conventional MRI,DWI and DTI in every case.The le-sions were observed and compared in different sequences imaging.Mean diffusivity(MD)and fractional anisotropy(FA)values of cere-bral infarction lesions and the symmetrical positions in normal hemispheres were measured and compared.The correlations between relative MD(rMD)value,relative FA(rFA)value and disease time were analyzed.Results The display rate on DWI in showing ultra-acute and acute cerebral infarction lesions was 100%,which was superior to that on other sequences of conventional MRI obviously (P0.05).MD value was higher at early chronic and late chronic phase(P0.05),but at the later separate phases,FA values reduced successively(P<0.001).The rMD value of infarction lesions was positive correlated with disease time(rs=0.990,P<0.001).The rFA value of infarction lesions was negative correlated with disease time(rs=-0.994,P<0.001). Conclusion DWI is susceptive in showing cerebral infarction lesions at hyper-early phase.DTI can be used to determine the clinical phase and appraise the inj ured extent of cerebral infarction accurately by measuring the parameters.Combination of DWI and DTI can provide a basis for clinical individual treatment programs selection and prognostic evaluation.
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Aim To investigate the effect of progester-one ( PROG) in protecting the neurons against impair-ment induced by the Aβ1-42 activated astrocytes, and the underlying molecular mechanism. Methods The astrocytes were divided into 5 groups: control, Aβ, and Aβplus PROG groups treated with 3 different con-centrations of progesterone for 24h. Then, Aβand pro-gesterone were removed, and neurons were co-cultured with the treated astrocytes. MTT assay was used to e-valuate the viability of cultured neurons; ELISA was used to detect the levels of IL-1βand TNF-αin culture media of astrocytes; immunofluorescence and Western blot were performed to detect the activation of NF-κB in astrocytes. Results PROG dose dependently pro-tected against Aβ1-42 activated astrocytes induced via-bility decrease in co-cultured neurons. Aβ induced release of IL-1β and TNF-α from astrocytes, and in-crease of NF-κB activity was abolished by progesterone treatment. Conclusion PROG protects the neurons through inhibiting the reactivity of astrocytes, and the underlying mechanism involves the NF-κB signal trans-duction.